Converting from group coverage to Medicare Advantage

Interim conversion process

All members turning 65 enrolled in groups that don't offer retiree plans will receive a letter saying they can enroll in Priority Health Medicare Advantage when they have their Medicare claim number and are ready to retire. It also tells them how to get their claim number if they don't have it already.

Members will have 3 ways to enroll:

• Use the online enrollment form - go to prioritymedicare.com
• Complete and mail in a paper enrollment form - open the MAPD enrollment form (153KB PDF)
• Call Priority Health Medicare enrollment toll-free at 888 389-6676, 24 hours a day, 7 days a week. TTY users should call 711.

Open a copy of the letter (1243KB PDF).

Note: Members who live outside of our Medicare service area will receive a letter inviting them to apply for Medigap coverage. Open the Medigap application.

Formal seamless conversion coming later this year

Seamless conversion allows eligible members to switch to a Priority Health Medicare plan just by giving us their Medicare claim number - not completing a full enrollment form. We're waiting for CMS to approve this process and expect to begin seamless conversion in September.

The process

Eligible members include those who:

• Are turning 65
• Are disabled and no longer qualify for group coverage
• Have COBRA coverage and are turning 65

We'll contact eligible members up to 5 times about easy enrollment starting 4 months before their 65^th birthday:

1. 120 days before their birthday: They'll get a letter introducing the easy option that includes a simple paper form they can complete to enroll or opt out and mail it back to us. They can also go online or call us. Open a sample letter (123KB PDF).
2. 113-106 days before their birthday: They'll get a phone call to confirm they received the letter and understand their options. 
3. 90 days before their birthday: They'll get a second letter reminding them they have 30 days left to switch or opt out. Includes the paper form and gives the option to go online or call us. Open a sample letter (123KB PDF).
4. 60 days before their birthday: Members become ineligible for seamless conversion and will receive a letter saying they can still enroll by completing a full enrollment form. Open a sample letter (123KB PDF).
5. 30 days before their birthday: They'll get a final phone call asking them what they've decided to do.

There are different versions or these letters depending on the member's current status and plan options available to them.

If a member switches to Medicare Advantage or opts out this easy way to switch any time during the process, they'll stop getting letters and phone calls.

Note: We won't contact groups that currently have Priority Health group MAPD, wrap plans or offer other retiree plans.